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Musicophilia: Tales of Music and the Brain, Revised and Expanded Edition Paperback – September 23, 2008
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Amazon Best of the Month, December 2007: Legendary R&B icon Ray Charles claimed that he was "born with music inside me," and neurologist Oliver Sacks believes Ray may have been right. Musicophilia: Tales of Music and the Brain examines the extreme effects of music on the human brain and how lives can be utterly transformed by the simplest of harmonies. With clinical studies covering the tragic (individuals afflicted by an inability to connect with any melody) and triumphant (Alzheimer's patients who find order and comfort through music), Sacks provides an erudite look at the notion that humans are truly a "musical species." --Dave Callanan --This text refers to an out of print or unavailable edition of this title.
From Publishers Weekly
Sacks is an unparalleled chronicler of modern medicine, and fans of his work will find much to enjoy when he turns his prodigious talent for observation to music and its relationship to the brain. The subtitle aptly frames the book as a series of medical case studies-some in-depth, some abruptly short. The tales themselves range from the relatively mundane (a song that gets stuck on a continuing loop in one's mind) through the uncommon (Tourette's or Parkinson's patients whose symptoms are calmed by particular kinds of music) to the outright startling (a man struck by lightning subsequently developed a newfound passion and talent for the concert piano). In this latest collection, Sacks introduces new and fascinating characters, while also touching on the role of music in some of his classic cases (the man who mistook his wife for a hat makes a brief appearance). Though at times the narrative meanders, drawing connections through juxtaposition while leaving broader theories to be inferred by the reader, the result is greater than the sum of its parts. This book leaves one a little more attuned to the remarkable complexity of human beings, and a bit more conscious of the role of music in our lives. (Oct.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.
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Top Customer Reviews
With this book, he has attacked music in the same way, delving deeply into his own experiences with music and deeply into what happens inside the minds and brains of many patients with various brain and nervous system anomalies which shed light on how our human body works vis-à-vis music. If you thought you understood music because you are a music lover, Sacks will open his bag of tricks and surprise and delight with novel aspects of music which few have heard of or discovered in their own lives, up until now. And once more he has changed my own life. This time, not in a pleasant way.
Did you ever notice a clock ticking in the room you were in? And once you've noticed the darn thing ticking how hard it is to get rid of the ticking? You cannot get it to stop ticking by conscious effort(1); the harder you try the more aware you become of its incessant tick, tock, tick, tock, tick, tock . . . Well, during his discussion of tinnitis(2) he describes various kinds of tinnitis, one of which matched a low level of tinnitis in my own ears, one of which I was hardly conscious of, until he mentioned it, I was plagued by my consciousness of it for several days, before I lapsed once more into blissful unawareness of it, but never again into blissful ignorance of it. Like Adam seduced by the apple that Eve-like Oliver offered, I have gotten knowledge of my tinnitis, and it become present whenever I think of or write about it. Let this be your warning, if you suspect you have low-level tinnitis, it may arise into consciousness while this review or the book, but rest assured, it will lapse once more into normal background noise in a short time.
I recall Betty Rankin, aka Big Mama of WWOZ.org fame, once saying over the radio, that she listened to WWOZ radio all night to help her sleep, and now I understand that she likely had enough tinnitis to otherwise keep her awake. My tinnitis is more like light hissing of a steam radiator, very constant and low volume, more like the white noise that some people buy and electronic generator for in order to help them sleep. Me, I have a white noise generator built-in.
In his Preface Sacks writes about music and quotes Schopenhauer, "The inexpressible depth of music — so easy to understand and yet so inexplicable, is due to the fact that it reproduces all the emotions of our innermost being, but entirely without reality and remote from its pain . . . Music expresses only the quintessence of life and of its events, never these themselves." On this point, I would respectfully disagree esteemed philosopher. Once when the French Academy was debating whether a bear could dance, a man by the window looked out and saw a dancing bear in the street. In the face of contradictory evidence, a philosophical argument cannot stand. To those alive today who agree with Schopenhauer's last statement above, I would merely ask them to visit New Orleans and observe and participate in how music is integrated into life and all of its events.
We use the expression a bolt from the blue to refer to ideas which come to us in a flash, but Sacks begins his book with a story of a man, a doctor, who was talking on a pay phone outdoors when he was hit by a lightning flash which laid him out on the ground, dead, for all practical purposes. He reports floating above the scene, watching a woman giving him CPR.
[page 4] Then I was surrounded by a bluish-white light . . . an enormous feeling of well-being and peace. The highest and lowest points of my life raced by me. No emotion associated with these . . . pure thought, pure ecstasy. I had the perception of accelerating, being drawn up . . . there was speed and direction. Then, as I was saying to myself, 'This is the most glorious feeling I have ever had' — SLAM! I was back."
Dr. Cicoria knew he was back in his own body because he had pain — pain from the burns on his face and his left foot, where the electrical charge had entered and exited his body — and, he realized, "only bodies have pain." He wanted to go back, he wanted to tell the woman to stop giving him CPR, to let him go; but it was too late — he was firmly back among the living. After a minute or two, when he could speak, he said, "It's okay — I'm a doctor!" The woman (she turned out to be an intensive-care-unit nurse) replied, "A few minutes ago, you weren't."
The police finally took the doctor home instead of the hospital and later tests by cardiologist showed no problems. Just when his life seemed to have returned to normal several weeks later, he developed an intense desire to listen to piano music. He didn't own a piano, so he got recordings to satisfy his craze.
[page 5] This was completely out of keeping with anything in his past. He did not have a piano in his house. What music he did listen to tended to be rock music.
With this sudden onset of craving for piano music, he began to buy recordings and became especially enamored of a Vladimir Ashkenazy recording of Chopin favorites — the Military Polonaise, the Winter Wind Etude; the Black Key Étude, the A-flat Polonaise, the B-flat Minor Scherzo. "I loved them all," Cicoria said. "I had the desire to play them. I ordered all the sheet music. At this point, one of our babysitters asked if she could store her piano in our house-so now, just when I craved one, a piano arrived, a nice little upright. It suited me fine. I could hardly read the music, could barely play, but I started to teach myself." It had been more than thirty years since the few piano lessons of his boyhood, and his fingers seemed stiff and awkward.
This was only an appetizer for what was to come. Soon he heard music in his head.
[page 5, 6] "The first time," he said, "it was in a dream. I was in a tux, onstage; I was playing something I had written. I woke up, startled, and the music was still in my head. I jumped out of bed, started trying to write down as much of it as I could remember. But I hardly knew how to notate what I heard." This was not too successful — he had never tried to write or notate music before. But whenever he sat down at the piano to work on the Chopin, his own music "would come and take me over. It had a very powerful presence."
The music in his head seemed to "come from Heaven" as Mozart said about his music. Soon a music teacher came to help write down his music. Other than that, this was "a solitary pursuit, between himself and his muse." (Page 7)
Suddenly out of nowhere, like a grace note in music which doesn't appear in the written score, Cicoria's love of music appears in his life and his life is enhanced by it. Dr. Cicoria's story inspired me to write this poem (Copyright 2010 by Bobby Matherne).
A grace note
not to be questioned
Whether it be
flat or sharp —
A grace note
a lucky strike
A lightning strike
not to be questioned
But to be enjoyed.
A grace note,
In his Preface, Sacks writes about the "extraordinary tenacity of musical memory" saying that "so much of what is heard during one's early years may be 'engraved' on the brain for the rest of one's life." Clearly he is correct about this, but he does not go far enough, lacking the insights of the science of doyletics which postulates that every event in one's life is "engraved" on the brain indefinitely. Not for the rest of ones life, however, because it is easy using the speed trace memory technique to remove events which would otherwise remain engraved for the rest of one's life. As one begins to understand how one removes consciously these engraved events from one's early life, one can see that many of events are removed unconsciously as one matures(4). These "engraved events" are called doylic events or simply doyles and for simplicity they are assumed be stored in doylic memory, which name is necessary to distinguish it from just plain memory (or cognitive memory). Doylic memory hold physical body states which includes a vast array of events in the body of the pre-five-year-old child: hearing, speaking, walking, handling objects, recognizing objects through their orientation, and various internal states we label generically as sadness, fear, anger, anxiety, joy, happiness, gladness, among many other states.
When I read the case history of Mrs. N. I wondered if a simple speed trace might have kept her from needing a partial temporal lobectomy.
[page 28] She had loved the Neapolitan songs, which reminded her of her childhood. ("The old songs," she said, "they were always in the family; they always put them on.") She found them "very romantic, emotional. . . they had a meaning." But now that they triggered her seizures, she began to dread them. She became particularly apprehensive about weddings, coming as she did from a large Sicilian family, because such songs were always played at celebrations and family gatherings. "If the band started playing," Mrs. N. said, "I would run out. . . . I had half a minute or less to get away."
Since our research into doyletics has found that doylic memories which trigger migraine, asthma, allergies, rashes, and various kinds of automatic responses, it seems possible that a simple minute or two speed trace could remove the very trigger which caused her grand mal seizures. I leave this as an open question, but one could promise relief without surgery for many people who suffer various kinds of seizures. The trace procedure is very fast and after short training(5), it can be used by the patient on themselves upon the slightest symptom of the seizure coming on.
One of the keys to a general acceptance of the science of doyletics would be a physiological confirmation of the Memory Transition Age of five years old. Extensive traces going back 35 years have shown that if a doyle is traced back before the age of 5, it will not return while traces only going to ages 6 or older will allow the doyle to return at some future time. From the description of how the functional MRI scans were able to notice the filling of musical gaps, it seems clear that a functional MRI could provide physiological confirmation of the Memory Transition Age.
[page 33] Physiological confirmation of such "filling in" by involuntary musical imagery has recently been obtained by William Kelley and his colleagues at Dartmouth, who used functional MRI to scan the auditory cortex while their subjects listened to familiar and unfamiliar songs in which short segments had been replaced by gaps of silence. The silent gaps embedded in familiar songs were not noticed consciously by their subjects, but the researchers observed that these gasp "induced greater activation in the auditory association areas than did silent gaps embedded in unknown songs; this was true for gaps in songs with lyrics and without lyrics."
A speed trace converts a doylic memory into a cognitive memory. The same stimulus which triggered the doylic memory before trigger thereafter only a cognitive memory. Thus the region where the doylic memory had been stored since before five (engraved in the brain) will be bypassed after a speed trace, and instead a section of the cortex will be activated. A functional MRI before a speed trace should show activity in the limbic region's amygdaline structures and none in the cortex, and after the trace, there should be no activity in the same limbic region, but activity showing up in the cortex itself. This research work will be an enormous boon to humankind. It will be done sometime, but why not now? The equipment and the hypotheses are ready for testing and confirmation.
Sacks described several instances of hallucinatory music playing in his head. Here is one of them.
[page 280] I had another musical dream, and this too continued into the waking state. Here, in contrast to the Mozart, I found something deeply disturbing and unpleasant about the music, and longed for it to stop. I had a shower, a cup of coffee, went for a walk, shook my head, played a mazurka on the piano — to no avail. The hateful hallucinatory music' continued unabated. Finally I phoned a friend, Orlan Fox, and said that I was hearing songs that I could not stop, songs that seemed to me full of melancholy and a sort of horror. The worst thing, I added, was that the songs were in German, a language I did not know. Orlan asked me to sing or hum some of the songs. I did so, and there was a long pause.
"Have you abandoned some of your young patients?" he asked. "Or destroyed some of your literary children?"
"Both," I answered. "Yesterday. I resigned from the children's unit at the hospital where I have been working, and I burned a book of essays I had just written. . . . How did you guess?"
"Your mind is playing Mahler's Kindertotenlieder," he said, "his songs of mourning for the death of children." I was amazed by this, for I rather dislike Mahler's music and would normally find it quite difficult to remember in detail, let alone sing, any of his Kindertotenlieder. But here my dreaming mind, with infallible precision, had come up with an appropriate symbol of the previous day's events. And in the moment that Orlan interpreted the dream, the music disappeared; it has never recurred in the thirty years since.
Once more Oliver Sacks has set a table before me with a feast of incredible stories and amazing insights. His willingness to share his own stories make all of his stories more believable. One can read two dozen books about how the human brain processes music or simply read this one. Sacks has done the homework for us, provided a crib sheet for us, and understanding the human brain just a little simpler for the non-neuroscientist reader. Something you can find out more about in Bobby Matherne's DIGESTWORLD Issue#105.
Oliver Sacks, a neurologist and physician from London, England, has practiced medicine for over forty years. He has always held a passionate interest in music, in fact, he claims that "'Music' has always been one of the first things [he looks up] in the index of any new neurology or physiology textbook." In his forty-year practice of medicine, he has come across a number of rare cases, particularly those with a focus on music as an ailment or as a treatment.
Musicophilia covers a variety of musically related topics in neuroscience. Sacks divides these topics into four main parts: First, the often haunting onset of the heightened sensitivity to music, followed by the relation of music to all senses of the body, then the strange presence of music in the lives of patients with mentally crippling disorders, and finally, the incredible impact (or lack thereof) of music in the lives of all people, even those without any kind of condition. Because he has been working with patients who experience auditory phenomena for almost 50 years, Sacks uses each chapter of his book to explain a particular case. Some chapters are filled with examples of patients who suffer or have come to terms with some kind of disorder; others, however, reflect on only one patient, perhaps indicative of the rarities of certain conditions. Most patients experience these conditions around older ages, but still some are born with them. The spectrum of these "musicophilic" or even "musicophobic" conditions is so vast that Sacks has truly pioneered the investigation into this field with his documentation of them.
In Musicophilia, Sacks first recounts his experiences with patients who had, at some point in their lives, suddenly felt the onset of a heightened sensitivity to music. In his very first chapter, "A Bolt from the Blue: Sudden Musicophilia", Sacks tells us of Tony C., a fit forty-two-year-old orthopedic surgeon who was in great health. Tony remembered vividly the moment his onset occurred: He was at a family gathering, and though the weather outside was pleasant, a few storm clouds had accumulated in the distance when he went to make a phone call to his mother. While at the pay phone, he could hear rain amidst the conversation he was having when, upon witnessing a flash come out of the phone, found himself falling backwards to the ground. He had been struck by lightning. Tony even found himself in the middle of an out-of-body experience, believing himself to be dead, but what was even more strange for him was that once he was resuscitated, a short time later he had an insatiable craving for music. Feeling now more alive than ever before, his newly-formed passion for music stole away his every desire. His wife couldn't even bear it, filing for a divorce, but Tony remained indifferent. To this day, Tony still works full-time as an orthopedic surgeon, but his entire being revolves around music.
Though this passion for music may be seen as a blessing, others may see it as a curse. In subsequent chapters of Part I, Sacks tells of patients who, upon hearing a familiar tune, would convulse uncontrollably. Faced with the rare condition of Musicogenic Epilepsy, many of these patients would live in fear of hearing that one familiar tune that set off the attacks, and so Sacks illustrates the need for research in curing that aurally crippling ailment. Sacks also discusses the mechanisms and regions of the brain responsible for musical imagination and continuous playback, as in the case of a catchy tune, until finally, he delves into the rare condition known as Musical Hallucination.
Part II of Musicophilia concerns the vast range of musicality that individuals possess, and Sacks covers topics in Amusia, Absolute Pitch, Dysharmonia, Savant Syndrome, and even Synesthesia. Sacks demonstrates just how fascinating some of these conditions may be in his stories, and in one case of absolute pitch he tells of a former professor of music at Oxford who could even tell what pitch came from the wind blowing or his father blowing his nose.
Sacks moves on from there, illustrating the relationship music has with vital processes such as movement and memory formation. He recounts histories of patients with Tourette's Syndrome, Amnesia, Parkinson's Disease, Phantom Limb Syndrome, and even Musician's Dystonia. All of these patients have suffered through some kind of somatic condition, losing some kind of normal kinesthetic or neural function, yet have used music therapeutically to help at least temporarily overcome their obstacles. Perhaps the most inspiring story comes with Nick van Bloss, an English pianist who had, since age seven, developed a severe form of Tourette's syndrome which created for him a life of ridicule and bullying. It was not until his parents bought a piano that his life became transformed for good. "When I played, my tics almost seemed to disappear. It was like a miracle," he said, and from that he found his passion for a life in music.
Musicophilia closes with Part IV, demonstrating how music is intertwined with emotion and even identity. Sacks states that "music, uniquely among the arts, is both completely abstract and profoundly emotional" (300). In one patient, Harry S., music is the only emotion able to be fully felt after suffering through a brain aneurysm. It is truly amazing to read of the ways music has helped these patients, and even in closing, Sacks shares a truly heartwarming story of how music therapy even brought back certain memories to a person who struggled with dementia.
When I listen to music, I feel wrapped in it entirely. It makes up such a major part of my life, and I know that it impacts so many others in much the same way. Oliver Sacks' Musicophilia demonstrates the countless ways music has helped others in their lives, including adverse conditions such as Savant Syndrome, Amnesia, even Dementia - and for this reason I rate Musicophilia a five out of five stars. It is truly inspiring to hear how many of these patients whom Sacks has interacted with have relied on music in their lives, and uplifting to hear how music has brought back good memories or normal functions in them. In much the same way, it is fascinating to hear of all those who have been tormented by musicogenic epilepsy, or even hallucinations, and I feel that Sacks' patient histories illustrate the need for future research in treating these ailments.
I would, however, make the caveat that Sacks does not write for a scientific audience. I have even searched for his case histories on PubMed, a large database of scientific research studies, and not a single story of his was there. His writing style is not intended for research, as he instead comments on the patient's psychosocial behaviors and lifestyle outside of the normal clinical setting. I have found that he spends almost as much time covering the history and lifestyle of a patient as he does covering the pathology of the specific condition, removing certain physiological or biochemical details but instead adding a poetic, humanistic feel to his tales.
All-in-all, Musicophilia is as eye-opening as it is ear-opening! I would recommend this book to anyone desiring to learn the neurological background to many musical conditions, as Sacks provides the framework in a simple yet humanistic way.